Slide 9

To treat peptic ulcer disease, it's important to determine if it's caused by H. pylori or NSAID use. If it's H. pylori, antibiotics, proton pump inhibitors, and bismuth for 14 days can eradicate the bacteria. If it's NSAID-induced, proton pump inhibitor therapy for six to eight weeks is most effective. Other treatments like H2 blockers, sucralfate, and misoprostol are less effective. Lifestyle changes like quitting smoking and managing stress can also help. In order to treat peptic ulcer disease, it is important to know if it is caused by H. pylori or by NSAID use. If the peptic ulcers are induced by H. pylori, then treatment would be to eradicate all H. pylori bacterium from the patient's digestive tract. Taking antibiotics, proton pump inhibitors, and bismuth for 14 days has an eradication rate greater than 90%. If NSAID-induced, peptic ulcers are most effectively treated with six to eight weeks of proton pump inhibitor therapy. Other less effective treatments include H2 blockers, sucralfate, and misoprostol. These are considered less effective because sucralfate is effective in treating duodenal ulcers but not gastric or esophageal ulcers, while misoprostol has poor efficacy and side effects including gastrointestinal upset. Lifestyle changes including the cessation of smoking, reduced alcohol consumption, limiting the intake of acidic foods, a low-sodium and low-fat diet, and stress management can help increase the efficacy of these treatments.